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BACKGROUND: Since the inception of the Youth Risk Behavior Surveillance System in 1991, all surveys have been conducted in schools, using paper and pencil instruments (PAPI). For the 2019 YRBSS, sites were offered the opportunity to conduct their surveys using electronic data collection. This study aimed to determine whether differences in select metrics existed between students who completed the survey electronically versus using PAPI. METHODS: Thirty risk behaviors were examined in this study. Data completeness, response rates and bivariate comparisons of risk behavior prevalence between administration modes were examined. RESULTS: Twenty‐nine of 30 questions examined had more complete responses among students using electronic surveys. Small differences were found for student and school response rates between modes. Twenty‐five of 30 adolescent risk behaviors showed no mode effect. CONCLUSIONS: Seven of 44 states and DC participated electronically. Because survey data were more complete; school and student response rates were consistent; and minor differences existed in risk behaviors between modes, the acceptability of collecting data electronically was demonstrated. [ABSTRACT FROM AUTHOR]

The Internet has become an inevitable tool for collecting health and health behavior questionnaires. This study compared the feasibility, presence of score differences, and subjective evaluations by children between Internet and identical paper (asthma/fruit) questionnaires in elementary schools. A randomized crossover design was applied, with children starting with one administration mode before completing (5 minutes later) the other mode. Ten Dutch elementary schools with 270 school children (fifth grade, 10-12 years) were approached to participate. Response was 92%. The Internet mode had significantly less missing/nonunique answers than the paper mode (p < .01). The completion times did not differ significantly between the Internet and the paper mode. Except for perceived self-efficacy to eat sufficient fruit (p < .05), no differences in the asthma and fruit scores were found when comparing between the 2 modes. All variables showed strong intraclass correlation coefficients (166 ≥ 0.64) between modes. Most items had good to very good agreement (kappa 0.61-0.95). The percentages for global and exact agreement ranged per item from 61.3 to 100. Most children preferred the Internet mode on “general preference” and “ease of use” aspects but rated no preference on “understandability.” The majority rated the evaluation aspects of the Internet mode positively. Thus, Internet administration of a health and health behavior questionnaire is feasible at elementary schools, gives comparable responses, and is well accepted and preferred by children compared to the paper version. Therefore, it is recommended to use Internet as a tool in health and health behavior research among children. (J Sch Health. 2006;76(2):80-86) [ABSTRACT FROM AUTHOR]

BACKGROUND: We analyzed data from a study to evaluate the effectiveness of the Relationships Under Construction (RUC) sexual risk avoidance education program promoting positive youth development and healthy relationships. METHODS: Twelve schools in the Midwestern region of the United States randomized to the intervention implemented RUC in health or science classes, while control schools collected study measures and implemented the standard curriculum. RESULTS: Post‐randomization analyses revealed significant differences in grade, race/ethnicity, and prior relationship education at baseline between intervention and control students. Subsequent analyses controlled for these differences. We distributed parental notification letters to 641 students, and no parents requested that their adolescent opt out of data collection. We obtained assent and baseline computer‐assisted survey interviews or paper‐and‐pencil instrument forms from 100% of these students. Findings suggest that RUC significantly reduced sexual activity (odds ratio = 0.56, p =.046) at 3‐month follow‐up, compared to those in the control group. RUC also reduced pornography viewing and improved attitudes about delayed gratification, beliefs, decision making, and negative outcome expectations. CONCLUSIONS: Our findings suggest that RUC improves sexual attitudes, beliefs, and behaviors among this population of adolescents. Additional research is needed to assess RUC impacts among diverse populations. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sexting is common among adolescents and is associated with numerous health risk behaviors and negative psychosocial constructs. This study examined the relationships between high school students' experiences with sexual violence victimization, dating violence victimization, and engagement in risky sexual behaviors with experiences of receiving sexts. METHODS: Cross‐sectional data from the 2014 to 2016 data from Pennsylvania Youth Risk Behavior. Participants were selected using an independent 2‐stage cluster sample design to produce a statewide population‐based sample. The pencil and paper surveys were conducted in school. Participants included 6734 Pennsylvania high school students in grades 9‐12. RESULTS: Overall, 29.0% of Pennsylvania high school students had received a sext, which varied by sex, race/ethnicity, school grade, and sexual identity. Students who engaged in sexual risk behaviors, experienced dating violence, or experienced lifetime sexual violence outside of the dating context had a significantly higher prevalence of receiving a sext than students who did not engage in those behaviors or have those experiences. CONCLUSIONS: Early screening and prevention efforts that include discussions about sexting behaviors may help prevent other negative outcomes, such as risky sexual behaviors and interpersonal violence. Addressing sexting in the education and health sectors may help to prevent other related harmful health and violence experiences during adolescence. [ABSTRACT FROM AUTHOR]

Background: School Health Profiles assesses school health policies and practices among US secondary schools. Methods: The 2020 School Health Profiles principal and teacher questionnaires were used for a test‐retest reliability study. Cohen's kappa coefficients tested the agreement in dichotomous responses to each questionnaire variable at 2 time points. The aggregate prevalence estimates between time 1 and time 2 were compared for each questionnaire item via overlapping 95% confidence intervals. Chi‐square tests examined whether the prevalence at time 2 differed between paper and web administration for both questionnaires. Results: For the principal (N = 50) and teacher (N = 34) data, there were no significant differences in the prevalence of any items between time 1 and time 2. For the principal survey, the mean kappa for 191 variables was 0.49. For the teacher survey, the mean kappa for 260 variables was 0.65. Overall, 60.7% of principal and 91.1% of teacher questionnaire items had at least "moderate" reliability. Conclusions: School Health Profiles offers education and health agencies a reliable tool to monitor school policies and practices. [ABSTRACT FROM AUTHOR]

BACKGROUND: Youth may be reluctant to seek health care from school health providers due to feeling embarrassed or stigmatized in the health office environment or worried about their confidentiality. The purpose of this project was to create a set of youth‐centered health posters that promote youth engagement with nursing staff and to standardize health messaging across high schools in Hawaii school‐based clinics. METHODS: Two community advisory boards, 1 composed of 10 youth stakeholders (mean age 17 years) and the other of 7 adult stakeholders, informed poster development utilizing web‐based discussion groups. The discussions were transcribed, and additional data was collected using field notes and anonymous digital messages. Adult advisory board members also provided feedback on suggested poster text through an online survey. RESULTS: Youth and adult advisory board participants identified 4 key health concerns facing youth: confidentiality, sexual health, relationships, and mental health. Based on input from the 2 advisory boards, 4 posters were developed, each centered on 1 key health issue. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: School‐based posters can convey important messages to help youth understand their health care rights and responsibilities, as well as identify important issues open for discussion with nurses. CONCLUSION: Posters are an underutilized tool for school health providers to create welcoming, inclusive health care environments and facilitate health‐related conversations with youth. This paper describes participant feedback about the characteristics of a memorable poster and briefly outlines current knowledge and recommendations for school health providers regarding each of the 4 health issues. [ABSTRACT FROM AUTHOR]

BACKGROUND: Schools are important arenas for the promotion of critical health literacy (CHL) among adolescents. Key domains of CHL are information appraisal, understanding social determinants of health, and abilities to act on determinants of health. In this paper, we examine the psychometric properties of the Critical Health Literacy for Adolescents Questionnaire (CHLA‐Q). METHODS: A cross‐sectional survey study was performed at 5 schools in Norway. Respondents included 522 pupils aged 13‐15 years old. Confirmatory factor analysis (CFA) was conducted to examine the structural validity. Internal reliability was assessed using ordinal Cronbach's alpha. RESULTS: The estimated model had acceptable closeness of fit. Five of 6 scales displayed adequate internal reliability. CONCLUSION: The results indicate acceptable fit of the CHLA‐Q framework and that 5 of the 6 scales are applicable to inform future research and interventions. More research is needed on measurement of the second domain of CHL. [ABSTRACT FROM AUTHOR]

BACKGROUND: The School Health Policies and Programs Study (SHPPS) is a national study periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. For SHPPS 2006, district-level questionnaires were designed for telephone administration, but mixed-mode data collection that also used paper-and-pencil mail questionnaires was required to obtain an acceptable response rate. Because most mode effect research has involved person-level rather than institution-level data, little is known about the effects of mixed-mode data collection on data quality and prevalence estimates obtained through surveys of school personnel. METHODS: SHPPS 2006 used 1-stage stratified cluster sampling to select a nationally representative sample of public school districts. Personnel in about half of the 538 responding districts completed paper questionnaires and returned them via mail. Analyses were performed comparing data quality and prevalence estimates for mail and telephone administration. RESULTS: Prevalence estimates for only 7.0% (39) of 554 questions tested across the 7 questionnaires differed significantly by response mode at the p < .01 level. Regarding data quality, use of the “don't know” response was higher for telephone administration. CONCLUSIONS: The results of this study demonstrate that SHPPS 2006 successfully used a mixed-mode approach, allowing the data to be used without concern about the mixed-mode administration. The results may also be useful to other researchers interested in using surveys to collect data on schools or school districts or other data that is not person level. [ABSTRACT FROM AUTHOR]

BACKGROUND: Concerns have been raised over teachers' mental health literacy in low‐income countries and lower‐ and middle‐income countries wherein pediatric mental health resources are limited. This study aims to investigate adolescent depression literacy among teachers in Eswatini and to explore the role of urbanicity. METHODS: We conducted a cross‐sectional survey in 59 public high schools in Eswatini in 2019‐2020. Data were collected by a paper‐and‐pencil questionnaire; depression literacy was assessed by the 17‐item Adolescent Depression Knowledge Questionnaire. RESULTS: Teachers' adolescent depression literacy item‐level correct rates fell between 27 and 80%. Although the multivariate response models indicated that teaching in urban areas was slightly associated with having higher depression literacy in general (adjusted odds ratio [aOR] = 1.46; 95% confidence interval = 1.00‐2.12), such urban‐rural differences did not manifest homogeneously across all items: urban teaching was significantly linked with reduced correct responses toward certain items concerning depression etiology and treatment, including "depression runs in some families," "major stress as a necessary cause," and "a curable illness" (aOR = 0.57 ∼ 0.68). CONCLUSION: Urban‐rural differences in teachers' depression literacy were manifested at both scale‐ and item‐levels. A critical need exists for urban/rural areas‐tailored intervention on teachers' literacy toward mental disorders in the resource‐limited regions to better improve health and developmental outcomes of students. [ABSTRACT FROM AUTHOR]

BACKGROUND: In this study, we examined nutrition‐related topics among adolescent students attending schools with different Indices of Community Socio‐Educational Advantage (ICSEA). METHOD: Participating students (N = 206) from 5 schools in Western Australia completed a paper‐based questionnaire on nutrition‐related topics. Frequencies and independent chi‐square tests were used to identify differences between sexes and school ICSEA. RESULTS: Of the participating students, 75% were interested in learning about 8 of 16 topics. We found statistically significant differences by sex (p <.01) for "Eating the right foods for preventing illness and disease," "Eating the right food for being active" among girls, and "Reducing food waste" among boys. We also noted differences by school ICSEA. CONCLUSION: Acknowledging sex and socioeducational differences in teaching and learning may help teachers to engage adolescent students in nutrition education. [ABSTRACT FROM AUTHOR]

BACKGROUND Mental health services in the United States public schools are an important component of the academic success of a student. Not all schools, however, have the necessary personnel and funding to offer such services. METHODS: In this paper, we provide an analysis of data collected from schools in 3 geographic locations. Comparisons were made of the availability of personnel to assess and treat mental health disorders in students enrolled in city, urban, and suburban schools, with over 10,000 schools represented. The data were part of the 2015 to 2016 School Survey on Crime and Safety. RESULTS: Accessibility of mental health practitioners and reasons that limited efforts of a school to provide the services were assessed. Statistically significant differences were identified by school location, demonstrating that those in rural communities were most challenged providing diagnostic assessment and treatment for students by school mental health professionals, for several reasons. CONCLUSIONS: Increased state and county funding to support mental health practitioners in public high schools is one suggestion to address mental health disorders in students. Other strategies are offered for timely and appropriate diagnoses and treatment for mental health disorders that may impact the quality of life of a student for a lifetime. [ABSTRACT FROM AUTHOR]

BACKGROUND: Through the Texas Childhood Obesity Research Demonstration study, we implemented and evaluated a system‐oriented model of primary and secondary prevention approaches to mitigate obesity among low‐income Texas children aged 2 to 12 years. Primary prevention included implementing the Coordinated Approach To Child Health Early Childhood (CATCH EC) program in Head Start preschools. In this paper, we describe the methods and results of CATCH EC program process evaluation over 2 years of implementation. METHODS: We used a quasi‐experimental design with serial cross‐sectional data collected from Head Start centers across intervention and comparison catchment areas in Houston and Austin, Texas (intervention: N = 12 centers in 2012‐2013 [Year 1], N = 12 in 2013‐2014 [Year 2]; comparison: N = 13 centers in Year 1, N = 12 in Year 2). Process evaluation included center director and teacher surveys conducted in both years of implementation. We developed indices for implementation of CATCH EC and non‐CATCH health events at the centers. RESULTS: Implementation scores were higher among intervention centers as compared to comparison centers across both years of implementation, and these differences were statistically significant (p < .01). There was also high variability in program implementation in intervention centers across both years ranging from 55% to 95%. CONCLUSION: These implementation index strategies may inform future evaluation of preschool‐based obesity prevention program implementation. [ABSTRACT FROM AUTHOR]

ABSTRACT: BACKGROUND: Significant proportions of young people experience body dissatisfaction, which has implications for psychological and physical well‐being. Lesson content and perceived competence may be important variables for the experience of body dissatisfaction, yet these have been underexplored in physical education. The aim of this cross‐sectional study is to identify the relationships between body dissatisfaction and perceptions of competence, and to explore whether body dissatisfaction depends on lesson content. METHODS: A paper‐and‐pencil questionnaire was completed by 446 (210 boys, 236 girls) 13‐ to 14‐year‐old pupils from 37 physical education classes. The questionnaire assessed body dissatisfaction and perceived competence in physical education. Lesson content was also recorded. Twenty‐nine of the classes were engaged in team activities, eg, ball games. Eight classes were engaged in individual activities, eg, fitness. RESULTS: Multilevel analysis identified a significant negative association between body dissatisfaction and perceptions of competence in physical education. Lesson content did not significantly predict variations in body dissatisfaction scores. CONCLUSIONS: Teachers should focus on enhancing pupils' perceptions of competence in physical education to support the development of body satisfaction. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Adolescent overweight and obesity are serious health risks, with prevalence varying by sociodemographic group. Studies link children's weight status and sex/race-ethnic differences with meeting recommendations for physical activity and diet. But, research examining the intersection of sociodemographic characteristics, behavior, and weight status is limited. This paper aims to identify sociodemographic differences in the association between adolescent weight status and meeting 6 national obesity-related recommendations. METHODS In 2011-2012, the Healthy Kids Colorado Survey was administered to all Denver high school students. Using descriptive and multivariate modeling, we examined subgroup associations between students' self-reported weight status and physical activity and diet. RESULTS Students (N = 6652) who met at least 1 recommendation were less likely to be at an unhealthy weight (OR = 0.87); also true for students who met at least 1 physical activity recommendation (OR = 0.80). However, the association varied across subgroups. The association between weight status and meeting at least 1 nutritional recommendation (OR = 0.91) was inconsistent across subgroups. Unexpected patterns also emerged in subgroup associations between meeting specific recommendations and weight status. CONCLUSIONS Identifying subgroup differences in meeting recommendations and the association with weight status is important in identifying high risk groups and improving policy and programs that target childhood obesity prevention. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND This study describes the perceived impact of H1N1 influenza and the adoption of the recommended measures to address the pandemic in schools. METHODS A cross-sectional self-reported survey was conducted in 433 schools in Barcelona addressed to the school principal or the H1N1 influenza designated person. A descriptive analysis was performed, stratifying by educational level and type of school. A logistic regression analysis also was conducted. RESULTS Around 70% of the respondents reported that there had been H1N1 influenza cases among students, being this percentage significantly higher among those schools offering primary education (74.4%) (p < .05). The main measures (single-use paper towels, availability of sanitizer solutions and 15 minutes ventilation per day of enclosed spaces) were implemented in most of the centers. However, the correct adoption of the main measures took place in around 30% of the schools, being the percentage lower in those offering only secondary education (Odds ratio [OR]: 0.518; 95% confidence interval [CI]:0.272-0.986) and those located in medium (OR: 0.438, 95% CI: 0.234-0.811) or low socioeconomic status (SES) districts (OR: 0.321, 95% CI: 0.159-0.649). CONCLUSIONS Despite the climate of social alarm, the perceived impact of H1N1 influenza in most schools was moderate. In future potential threats, the educational level and the SES of the school should be considered, especially when measures requiring purchasing any product are recommended but not provided. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The aim of this study was to assess the beliefs and attitudes of preservice health and physical education ( HPE) specialist and nonspecialist schoolteachers toward obese children. METHODS A total of 177 nonspecialist and 62 HPE specialist trainee teachers completed a series of pen-and-paper validated measures of attitudes and beliefs toward obese children. RESULTS Both groups of preservice teachers reported strong implicit and moderate explicit anti-fat bias. Enrollment in the HPE specialist degree was found to be a significant predictor of both implicit bad/good anti-fat bias (β = 3.97, p = .002) and implicit bias on the stupid/smart scale (β = 2.983, p = .016) of the IAT. Beliefs that obese children were less healthy, more self-conscious, and less satisfied with themselves were strongly endorsed by the majority of participants. HPE specialists were found to have significantly lower expectations for obese children in regard to 'reasoning' (mean difference = 0.21, p = .0107) and 'cooperation' skills (mean difference = 0.25, p = .0354) compared to nonspecialist trainees. CONCLUSIONS This study is the first to document the strong anti-fat bias of both preservice nonspecialist and HPE specialist teachers. It is also the first to find that preservice HPE specialist teachers have stronger anti-fat biases and differential expectations regarding particular abilities of obese children, compared to nonspecialists. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Approximately 9% of school-aged children in the United States have asthma. Since 1997, the Asthma Action Plan ( AAP) has been recommended as an asthma self-management tool for individuals with asthma. In the school setting, the use of the AAP has been primarily dependent on communication between the family and the school through a paper process. METHODS To address the limited availability of AAPs, the Southeast Minnesota Beacon Project developed and implemented a secure portal designed for the electronic exchange of the AAP between providers and schools. This project was designed to assess school nurses' responses to the portal and the perceived value of AAPs, efficiency, self-efficacy, and project impact. RESULTS School nurses perceive that the AAP enables more efficient management of the care of students with asthma and increases school nurse self-efficacy in regard to asthma management. Overall, school nurses felt the AAP portal was useful and they reported satisfaction with its function as a school health office resource. CONCLUSION Electronic sharing of the AAP has the potential to increase efficiency and enhance effective communication among health care providers, families, and schools. [ABSTRACT FROM AUTHOR]

BACKGROUND: Those involved in school health education programs generally believe that health-education programs can play an important role in helping young people make positive health decisions. Thus, it is to document the effects of such programs through rigorous evaluations published in peer-reviewed journals. METHODS: This paper helps the reader understand the context of school health program evaluation, examines several problems and challenges, shows how problems can often be fixed, or prevented, and demonstrates ways in which challenges can be met. A number of topics are addressed, including distinguishing between curricula evaluation and evaluation of outcomes, types of evaluation, identifying stakeholders in school health evaluation, selection of a program evaluator, recruiting participants, design issues, staff training, parental consent, instrumentation, program implementation and treatment fidelity, participant retention, data collection, data analysis and interpretation, presentation of results, and manuscript preparation and submission. RESULTS: Although there is a lack of health-education program evaluation, rigorous evaluations that have been conducted have, at least in some cases, led to wider dissemination of effective programs. CONCLUSIONS: These suggestions will help those interested in school health education understand the importance of evaluation and will provide important guidelines for those conducting evaluations of school health-education programs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Over the last 3 decades, US obesity rates have increased dramatically as more children and more adults become obese. This study explores an innovative program, Active Generations, an intergenerational nutrition education and activity program implemented in out-of-school environments (after school and summer camps). It utilizes older adult volunteers to implement a version of the evidence-based childhood obesity prevention program, Coordinated Approach to Child Health, in 8 US cities. METHODS: Approximately 760 children in third- to fifth-grade participated in Active Generations, a 10-lesson, intergenerational, childhood obesity prevention program. Children completed an age-appropriate survey instrument, the Active Generations survey (AGS). The AGS is a valid and reliable, self-administered, self-report, paper-and-pencil survey designed to assess knowledge, attitudes, and behaviors. It was administered by trained volunteers on the first day and last day of the program. Constructs assessed included physical activity, nutrition, and media use. RESULTS: Students significantly increased their reported fruit and vegetable consumption post-program. For example, the percentage of students reporting eating 3 or more servings of vegetables per day was 16% greater post-program. Students were more likely to report reading food labels and greater confidence that they could participate in physical activity. They also significantly decreased their daily screen time. CONCLUSIONS: Active Generations is a promising childhood obesity prevention program. [ABSTRACT FROM AUTHOR]

Background: The association between early childhood psychosocial problems and poorer educational outcomes is well‐documented, but the extent to which this association persists is less understood. The current study assessed the correlations between first‐grade psychosocial functioning and educational outcomes through eighth grade in a large longitudinal sample of Chilean students. Methods: The Pediatric Symptom Checklist‐Chilean (PSC‐CL) and Teacher Observation of Classroom Adaptation Re‐Revised (TOCA‐RR) assessed psychosocial functioning for 9736 students who were screened four times from first through eighth grade through the Skills for Life program. Adjusted linear mixed effects models assessed the association between first grade PSC‐CL and TOCA‐RR risk and third, sixth, and eighth grade GPA and school attendance. Results: First‐grade PSC‐CL and TOCA‐RR risk both significantly predicted lower third, sixth, and eighth grade GPAs; all p <.001. The relationships between first‐grade psychosocial functioning and later school attendance rates were less consistent but still significant at certain time points. Conclusions: First‐grade psychosocial risk was persistently associated with lower academic performance in a longitudinal sample of Chilean students followed through elementary and middle school. Implications for School Health Policy, Practice, and Equity: Early school‐based psychosocial screening and follow‐up interventions have the potential to improve students' long‐term educational outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND: In 2020, schools shifted to remote learning in response to mitigating COVID‐19. Since then, students have fluctuated between in‐person and remote learning environments. Changes to instructional models raise questions about the impact on health. METHODS: This study leveraged a statewide surveillance system (Healthy Kids Colorado Survey) to examine the relationship between learning environment and adolescent health. The survey was administered in Fall 2020 to 26 high schools, resulting in 4564 respondents. RESULTS: Overall, results suggested positive and negative associations between the 3 learning environments. Notably, as compared to in‐person students, hybrid and remote students reported more stress (OR = 1.82, p <.001; OR = 1.41, p =.001), less school connectedness (OR = 0.71 and 0.61, p <.001); remote students reported more parental abuse (OR = 1.33, p =.010) and less alcohol consumption (OR = 0.61, p <.001). CONCLUSION: This study may be used to better understand risk and protective factors experienced by youth at school and home with the goal of improving prevention strategies. [ABSTRACT FROM AUTHOR]

BACKGROUND: School principals usually have to sacrifice health and family obligations to obtain sufficient work time. This study investigates school principals' somatic and psychological discomfort related to their time allocation to diverse work contexts and life domains, so as to test the optimal allocation of time to each context and domain. METHODS: This study is based on survey data of 347 school principals, from the preexisting 2021 Survey of School Teachers' Living Conditions in Shanghai. Generalized linear regression modeling was adopted to analyze the data according to the research purpose. RESULTS: This study finds that school principals' daily time spent on work at home, sleep, breakfast, exercise, and family obligations significantly predict their somatic or psychological discomfort. However, their time spent on work at school, daytime napping, lunch, and dinner are not of significance. CONCLUSIONS: This study reveals several unhealthy ways of working and lifestyle habits among school principals from a perspective of time allocation, such as extended periods working at home, sleep deficits, hurried breakfast, lack exercise, and failure to meet familial obligations. [ABSTRACT FROM AUTHOR]

Background: Adolescent behaviors and academic outcomes are thought to be shaped by school climate. We sought to identify longitudinal associations between school climate measures and downstream health and academic outcomes. Methods: Data from a longitudinal survey of public high school students in Los Angeles were analyzed. Eleventh‐grade health and academic outcomes (dependent variables, eg, substance use, delinquency, risky sex, bullying, standardized exams, college matriculation), were modeled as a function of 10th‐grade school climate measures (independent variables: institutional environment, student‐teacher relationships, disciplinary style), controlling for baseline outcome measures and student/parental covariates. Results: The 1114 student respondents (87.8% retention), were 46% male, 90% Latinx, 87% born in the United States, and 40% native English speakers. Greater school order and teacher respect for students were associated with lower odds of multiple high risk behaviors including 30‐day alcohol use (odds ratio [OR] 0.81; 95% confidence interval [CI] [0.72, 0.92] and OR 0.73; [0.62, 0.85]) and 30‐day cannabis use (OR 0.74; [0.59, 0.91] and OR 0.76; [0.63, 0.92]). Neglectful disciplinary style was associated with multiple poor health and academic outcomes while permissive disciplinary style was associated with favorable academic outcomes. Implications for School Health Policy, Practice, and Equity: School health practitioners may prospectively leverage school environment, teacher‐student relationships, and disciplinary style to promote health and learning. Conclusions: Our findings identify specific modifiable aspects of the school environment with critical implications for life course health. [ABSTRACT FROM AUTHOR]

BACKGROUND: About 20‐30% of children worldwide report depressive symptoms. This study examined associations between children's depressive symptoms, life events, and family factors. METHODS: Nationally representative data (n = 95,725) were drawn from the 2017 School Health Promotion Study in Finland. The respondents were 4th and 5th grade pupils (aged 10‐12) in primary schools and their parents/guardians (n = 33,726). Data were analyzed for child‐parent dyads (n = 32,181). Associations were studied using cross tabulation and logistic regression models. RESULTS: Children's reports of poor self‐rated health, problems with family interactions, and the accumulation of life events were statistically significantly associated with depressive symptoms, also when controlling for sociodemographic factors. Financial situation and parent's depressed mood, both reported by parents, were associated with children's depressive symptoms when both were included in the regression model. However, this association disappeared when other predictors were added to the model. CONCLUSION: The results make apparent the complex associations between children's depressive symptoms and family factors. Further research is needed on the discrepancies between parent and child experiences. [ABSTRACT FROM AUTHOR]

BACKGROUND: We examined fidelity and feasibility of implementation of COVID‐19 preventive measures in schools, and explored associations between adherence to these measures and staff well‐being, to inform policy on sustainable implementation and staff wellbeing. METHODS: Surveys were conducted across 128 schools in England with 107 headteachers and 2698 staff‐members with reference to autumn term 2020, examining school‐level implementation of preventive measures, adherence, and teacher burnout (response rates for headteacher and staff surveys were 84% and 59%, respectively). RESULTS: The median number of measures implemented in primary and secondary schools was 33 (range 23‐41), and 32 (range 22‐40), respectively; most measures presented challenges. No differences were found regarding number of measures implemented by school‐level socio‐economic disadvantage. High adherence was reported for staff wearing face‐coverings, staff regularly washing their hands, (secondary only) desks facing forwards, and (primary only) increased cleaning of surfaces and student hand‐washing. Adherence to most measures was reported as higher in primary than secondary schools. Over half of school leaders and 42% (517/1234) of other teaching staff suffered from high emotional exhaustion. Higher teacher‐reported school‐wide adherence with measures was consistently associated with lower burnout for leaders and other teaching staff. CONCLUSIONS: Findings indicate a tremendous effort in implementing preventive measures and an urgent need to support investments in improving teacher wellbeing. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Influenza is a cause of considerable morbidity in England, particularly among children. A total of 39% of all influenza-attributable general practitioner consultations and 37% of all influenza-attributable hospital admissions occur in those aged under 15 years. Few studies have quantified the impact of influenza outbreaks on families. We assessed this impact during 2 influenza seasons. METHODS We used questionnaires to obtain data in primary schools that reported an outbreak of an influenza-like-illness ( ILI). We sought data on the loss of productivity, costs borne by families and loss in health-related quality of life (HRQoL). ILIs were identified using the symptoms criteria from the European Centre for Disease Prevention and Control and the UK Flusurvey. RESULTS For each child reporting ILI, mean school absence was 3.8 days (95% confidence interval [ CI]): 3.0-4.8) with mean work absence for caregivers reported as 3.7 days (95% CI: 2.7-4.8). The mean loss in HRQoL was 2.1 quality-adjusted life days (95% CI: 1.5-2.7). The estimated total pediatric burden of disease for reported school-based outbreaks during the 2 influenza seasons was 105.3 QALYs (95% CI: 77.7-139.0). CONCLUSIONS This study shows the potential social and economic benefit of vaccination of children during mild influenza seasons. [ABSTRACT FROM AUTHOR]

Background: Concussion public policies have been developed to address the burden of concussions. The aim of the present study was to examine implementation compliance, barriers, and facilitators of Canada's first concussion public policy, Ontario's Policy/Program Memorandum 158: School Board Policies on Concussion (PPM158). Methods: An electronic survey was sent to 515 randomly selected elementary and high school principals across specific geographic, language, and publicly funded school types in Ontario. Data were analyzed using both qualitative and quantitative methods. Results: One hundred and thirty‐five principals responded to the survey (26%). Concussion education was provided to teachers in 81% of schools, to students in 83%, and coaches in 79%. Additionally, 89% reported having a return‐to‐learn protocol in place and 90% reported having a return‐to‐play protocol. Implementation barriers included difficulties in providing concussion education to parents (42%), obtaining notes from physicians, and maintaining the volume of documentation. Eighty‐seven percent of respondents believed that PPM158 improves student well‐being. Conclusions: Identified implementation barriers and facilitators can inform concussion policy practices to improve student well‐being. We recommend: (1) an appointed concussion policy lead at each school, (2) electronic documentation, (3) determining the optimal education format to improve parent/guardian education, (4) fostering relationships between schools and health care professionals, and (5) student concussion education in every grade in Ontario schools. [ABSTRACT FROM AUTHOR]

BACKGROUND: The school food environment is a critically important area to target the health of millions of students, especially those experiencing food insecurity. However, both students and caregivers have noted significant barriers to participation in the school meal program, including taste, lunchroom experience, and limited availability of fresh, healthy foods. There is a lack of qualitative research which considers both caregiver and adolescent perspectives, particularly among youth of color. METHODS: Forty‐seven students (77% Black) and 24 caregivers across 4 midwestern high schools participated in focus groups and key informant interviews assessing barriers and facilitators to school meal participation. We conducted thematic analysis of the data using matrix intersection queries and reviewing frequencies of relevant nodes to identify themes. RESULTS: Themes about the importance of freshness and quality of the foods served in the lunchroom emerged from both students and caregivers. CONCLUSIONS: Future research may explore differences in meal participation depending on types of vender, farm to school program status, and other local variations in public schools and determine whether they increase participation, reduce food insecurity, and increase diet quality. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although positive youth development (PYD) programs have demonstrated effectiveness in improving adolescent reproductive health outcomes, there is a lack of evidence on effective school‐based interventions designed especially for high school settings. This study examined the efficacy of Peer Group Connection (PGC‐HS), a school‐based PYD program, in improving sexual health outcomes for high school participants. METHODS: A total of 1523 ninth‐grade students at 18 schools were randomly assigned to be offered PGC‐HS or a classes‐as‐usual control condition during 2016 to 2017 and 2017 to 2018 school years. Impacts were assessed on three confirmatory and 6 exploratory outcomes via self‐reported participant questionnaire data collected at the beginning of 10th grade. RESULTS: Although the offer of PGC‐HS had no statistically detectable effect on confirmatory behavioral outcomes (sexual initiation, frequency of sex, and number of sexual partners) at 10th grade follow‐up, causal impact estimates indicate that PGC‐HS participants were less likely than control participants to ever have had vaginal sex. PGC‐HS participants also scored higher on decision‐making skills and perceived connection to peer connectedness. CONCLUSIONS: Results suggest that by building social and emotional skills and helping students form supportive peer relationships, PGC‐HS may encourage students to make healthier choices and avoid risky behaviors during a critical period in high school, thus, reducing the risk of pregnancy. [ABSTRACT FROM AUTHOR]

BACKGROUND: State recess laws are recommended to encourage adequate and equitable access to recess and its benefits, but the downstream effects of state recess laws are unknown. We examined the association of state recess laws with district‐level policy and school recess provision. METHODS: This is cross‐sectional analysis of the School Health Policies and Practices Survey, a US nationally representative sample of school districts (2016) and schools (2014). State‐level recess laws were coded as none, recommend, or require recess. Logistic and linear regression were used to examine the association between state law with district policies and school recess provision, respectively. Data from 2000 are presented to highlight changes in recess policy and provision over time. RESULTS: The odds of a district policy requiring recess were 2.22 and 2.34 times greater when state recess law recommended or required recess, respectively, compared to states with no recess policy. There were no significant differences in school‐level recess provision by state recess law but point estimates from 2000 indicated states without a law had the largest declines in recess provision over time. CONCLUSIONS: State recess laws are positively associated with district‐level policy. Effects at the school level are unclear and continued surveillance is needed. [ABSTRACT FROM AUTHOR]

METHODS: Using the Theory of Planned Behavior (Ajzen 1991) as a theoretical framework, this study examined what administrators and teachers at a public elementary school located in a district in Northeast Georgia communicated as to their salient behavioral beliefs (attitude), normative beliefs (subjective norms), and control beliefs (perceived behavioral control) relative to the implementation of the district's written recess policy. RESULTS: The results of this study demonstrated that teachers new to the field and those certified in early childhood education were more supportive of implementing the practice. The results further demonstrated that more experienced teachers and those certified in elementary education were less supportive. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: The findings in this study revealed that obtaining participant buy‐in was critical for the implementation and that targeted professional development would be a suitable vehicle for improving school health for students. CONCLUSIONS: The most cited reasons for support for the policy were an understanding that an unstructured break was beneficial for students and that participants considered it a non‐negotiable. The most cited reasons for a lack of support included more time needed for academics and a need for expanded behavioral consequences. [ABSTRACT FROM AUTHOR]

Background: We evaluated the association between availability of specific physical activity (PA) spaces and PA practices among adolescents within Mexican high schools (HS). Methods: Data were collected through an online survey applied to principals or person in charge of 4023 Mexican HS during the 2015‐2016 school year. Adequate PA was defined as moderate to vigorous intensity PA for ≥60 minutes/day, ≥5 days/week, whereas PA‐specific spaces were considered those that were available and specifically designed/used for PA. HS demographic factors were explored as covariates. Associations were estimated using a logistic regression model. Results: From total participating HS, 83.10% had at least 1 PA‐specific space and 31.07% had adequate PA practices. A higher number of PA‐specific spaces was associated with greater adequate PA practices (33% to 61%). Possibilities for adequate PA increased when: physical education (PE) classes were led by a designated PE teacher (OR 2.39; 95%CI: 2.03‐2.83); the number of enrolled students was higher (OR 1.78; 95%CI, 1.43‐2.22 and OR 2.23; 95% CI, 1.71‐2.89, second and third tertile, respectively); HS financing sources were autonomous or private (OR 1.76; 95% CI, 1.19‐2.60); and HS were located in northern Mexico (OR 1.27; 95%CI, 1.02‐1.57). Conclusion: PA‐specific spaces, designated PE teachers, and financing sources are important factors in achieving adequate PA within Mexican high schools. [ABSTRACT FROM AUTHOR]

BACKGROUND: Exposure to injury and violence early in life increases the risk of experiencing injury and violence later in life. In 2019, the top 3 leading causes of death among 15‐ to 18‐year‐olds in the United States were unintentional injury, suicide, and homicide. This study examines the extent to which schools promote injury and violence prevention. METHODS: This study examined injury‐ and violence‐related school policies and practices using nationally representative data from the 2014 School Health Policies and Practices Study. The social ecological model served as the theoretical framework to identify level of impact. RESULTS: For many injury‐related topics, more than 75% of schools nationwide had relevant policies and practices to address those topics. However, this study showed differences in schools' injury‐related policies and practices by urbanicity. CONCLUSIONS: Understanding and identifying gaps in school policies and practices is essential for reducing and preventing the injury and violence children experience. Collecting data on school policies and practices allows for better monitoring and evaluation to determine which are efficacious and aligned with the best available evidence. [ABSTRACT FROM AUTHOR]

BACKGROUND: In Spring 2020, Georgia public schools implemented remote learning to manage the spread of COVID‐19. This study explores the effects of remote schooling on the learning of young children in Georgia during the early COVID‐19 pandemic from the perspectives of school administrators and essential working parents. METHODS: A qualitative exploratory study was conducted with eight school administrators and 26 essential working parents of children in kindergarten through third grades of two rural and two urban schools in Georgia. Data collection included online surveys, virtual interviews and focus groups. Descriptive analyses of the demographics provided context to emerging themes from qualitative data. RESULTS: Most school administrators and parents reported declines in student learning and academic behavior related to remote learning. Lack of Wi‐Fi, technology, and digital literacy were often cited as barriers to learning. Challenges with remote learning were amplified for students and parents of vulnerable groups. CONCLUSIONS: The findings of this study illustrate the need to institute policies, procedures, and supports to maximize schools' ability to safely offer in‐person learning during the COVID‐19 pandemic. Considerations should be made of the needs of essential working parents, vulnerable populations, and the digital divide. [ABSTRACT FROM AUTHOR]

BACKGROUND: Little is known about trends in implementing skills‐based instruction in US schools, specifically for sexual and reproductive health (SRH). We examined state‐level trends in the percentage of US secondary schools teaching SRH skills in a required course in grades 6 to 8 and 9 to 12. METHODS: Representative data from 35 states participating across 6 cycles of School Health Profiles (2008‐2018) was analyzed. The prevalence of teaching four SRH skills was assessed through lead health education teacher self‐administered questionnaires. Logistic regression models examined linear trends in the percentages of schools teaching SRH skills in grades 6 to 8 and 9 to 12. Trends were calculated for states with weighted data (response rates ≥70%) for at least 3 cycles, including 2018. RESULTS: During 2008 to 2018, the median percentage of schools addressing each SRH skill ranged from 63.5% to 69.7% (grades 6‐8) and 88.2% to 92.0% (grades 9‐12). Linear decreases in SRH skills instruction were more common for grades 6 to 8 than grades 9 to 12; linear increases were comparable for both groups. Most states demonstrated no change in the percentage of schools teaching SRH skills in grades 6 to 8 and 9 to 12. CONCLUSIONS: Limited changes and decreases in SRH skills instruction in US secondary schools suggest efforts to strengthen SRH education are needed. [ABSTRACT FROM AUTHOR]

BACKGROUND Being bullied online is associated with being bullied in school. However, links between online bullying and violence‐related experiences are minimally understood. We evaluated potential disparities in these associations to illuminate opportunities to reduce school‐based violence. METHODS: We used five cohorts of Youth Risk Behavior Survey national cross‐sectional data (2011‐2019, Ntotal = 73 074). We used survey‐weighted logistic and multinomial models to examine links between online bullying and five school‐based violence‐related experiences: offline bullying, weapon carrying, avoiding school due to feeling unsafe, being threatened/injured with a weapon, and physical fighting. We examined interactions by sex, race/ethnicity, and sexual identity. RESULTS: Being bullied online was positively associated with all offline violence‐related behaviors. Groups with stronger associations between online bullying and physical fighting, including boys, adolescents whose sexual identity was gay/lesbian or unsure, and many adolescents of color (Black, Hispanic/Latino, and Asian/Pacific Islander adolescents), had stronger associations between online bullying and either weapon carrying or avoiding school. CONCLUSIONS: Online bullying is not an isolated harmful experience; many marginalized adolescents who experience online bullying are more likely to be targeted in school, feel unsafe, get in fights, and carry weapons. Reduction of online bullying should be prioritized as part of a comprehensive school‐based violence prevention strategy. [ABSTRACT FROM AUTHOR]

Background: There is a gap in the literature regarding data on sexting among youth under the age of 16 whereas the problems related to this practice could affect them more because of their ongoing development. This study aims to determine the prevalence rate and characteristics of sending one's own sexually related image among middle‐school teens. Methods: Data were obtained from a web‐based in‐school survey conducted between October 2019 and February 2020. The sample comprised 3006 (mean age 13.7; 50.2% males) 10th‐grade pupils in the canton of Vaud (Switzerland). Participants were asked "Have you ever sent a sexually related/sexy image of yourself?". Analysis of variance/chi‐square tests and multinomial regression analyses were used to compare the groups. Results: Overall, 93.0% reported never, 3.7% once and 3.3% several times. No gender differences were found. Sending was associated with older age, low academic performance, cyberbullying victimization and reception of unsolicited sexually related images. Conclusions: Education and health professionals should be aware that it is necessary to discuss the theme, perhaps with a more global approach including pressure, consent, exchange of nonsexual images, and so on from an early age. The context and reasons for sending remain to be explored, particularly to determine if the pressure is greater at this age. [ABSTRACT FROM AUTHOR]

BACKGROUND: Developmental assets foster positive health outcomes among adolescents, but have not been studied in adolescents with chronic illness or depression, two conditions that impact behaviors in school. We examined parent‐reported assets in a national sample of adolescents and compared the number and types of assets by health statuses. METHODS: Data were from the 2016 National Survey of Children's Health (N = 15,734 adolescents), which captured 15 of 40 assets in the Developmental Assets Framework. We categorized adolescents as healthy; chronic physical illness alone; depression alone; and chronic physical illness with co‐morbid depression. Data were analyzed using analysis of variance and logistic regression. RESULTS: Healthy adolescents and those with chronic physical illness alone were comparable in number and types of assets. Adolescents with chronic physical illness and co‐morbid depression had fewer assets compared to healthy adolescents and those with chronic physical illness alone. Similar associations were found in comparing healthy adolescents to those with depression without chronic physical illness. CONCLUSIONS: The presence of depression, among adolescents with and without chronic physical illness, was associated with fewer internal and external assets. The absence of assets may serve as a unique indicator of underlying depressive symptoms among adolescents in the school setting. [ABSTRACT FROM AUTHOR]

BACKGROUND: To inform prevention strategies, this study provides incidence, factors, and actions taken when a suspected concussion occurred in K‐12 schools in Utah. METHODS: Data were collected using Utah's Student Injury Reporting System (SIRS) from the academic years 2011‐2012 to 2018‐2019. SIRS is a unique online system that tracks injuries that occur in the school setting among K‐12 students in Utah. Descriptive statistics were computed to characterize students with a suspected concussion. Chi‐square (χ2) analysis looking at characteristics by school level was also conducted. RESULTS: Over 63,000 K‐12 students in Utah sustained an injury at school during the study period. Suspected concussions comprised 10% of all injuries. The prevalence of concussions was highest among males (60.6%) and elementary school students (42.6%) and most often occurred outdoors (57.6%) or on a playground/playfield (33.9%), and in sports‐ and recreation‐related activities (75.1%) (specifically contact sports, 24.0%). Most students with a suspected concussion were absent 1 day or less from school (71.4%) but about 68% were seen by a medical professional. Further, there were differences by school level. Females and students playing contact sports had a higher percentage of suspected concussions as school level increased, whereas males and concussions sustained during school hours had a lower percentage of suspected concussions as school level increased. CONCLUSIONS: SIRS enables schools in Utah to identify groups at risk for concussion, as well as activities most commonly associated with these injuries, within the school environment. Using this information, schools may implement targeted prevention strategies to protect students. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health emergencies managed by school nurses. METHODS We used data from a New Mexico public school nurse workforce survey to describe the involvement of school nurses in managing adolescent behavioral health emergencies. We included all respondents who self-identified as working in a secondary school (N = 186). We conducted descriptive analyses. RESULTS Two thirds of survey respondents had provided emergency management in the prior school year for child abuse or neglect, depression, and violence at school. Over 40% had provided emergency management for a suicidal student in the prior school year. Although almost 80% of respondents identified 'violence at school' as a very important continuing education topic, 40% reported having received continuing education on this topic in the prior 5 years. CONCLUSIONS In New Mexico, public school nurses provide substantial amounts of emergency management for adolescent behavioral health problems. Continuing education received by school nurses on behavioral health emergencies may not be commensurate with their clinical responsibilities. [ABSTRACT FROM AUTHOR]

BACKGROUND: Little is known about the effectiveness of school district concussion policies on reducing the concussion prevalence among students. METHODS: Data from the 2016 School Health Policies and Practices Study and 2017 Youth Risk Behavior Survey for 10 school districts were linked. The outcome variable was having a sports‐ or physical activity‐related concussion during the 12 months before of the survey. Exposure variables were 2 district policies, including district‐funded professional development and prioritizing return to the classroom before returning to athletics. Logistic regression models estimated the odds of a concussion among students in districts with one, both, or neither policy (referent). RESULTS: In districts with district‐funded professional development, the odds of students self‐reporting ≥2 sports‐ or physical activity‐related concussions were 1.4 times higher than in districts with neither policy. In districts with a policy prioritizing a return to the classroom before returning to athletics, the odds of students self‐reporting ≥2 concussions were significantly lower (OR = 0.6) than in districts with neither policy. CONCLUSION: School district concussion policies may have positive effects by identifying and reducing multiple concussions among students. [ABSTRACT FROM AUTHOR]

BACKGROUND: Adolescence coincides with the adoption of health behaviors that schools are not necessarily equipped to properly address. Collaboration between schools and external health services such as public health could fill gaps in addressing student health. METHODS: The current study uses student‐ and school‐level survey data from 59 nonprivate secondary schools in Ontario, Canada in year 6 (2017–2018) of the COMPASS study to examine barriers to improving student health, and analyze the effect of public health engagement on student health behaviors. RESULTS: The majority of schools have received resources from their local public health unit, however, less than one third of schools were developing/implementing programs jointly, and 12% of schools reported no engagement. Students had higher odds of better overall mental health, of meeting screen time guidelines, and were less likely to bully others if public health units solved issues together with schools regarding these health behaviors. CONCLUSIONS: There is a notable lack of consistent public health engagement in schools participating in the COMPASS study despite a need for such services. Creating mechanisms to develop and strengthen effective partnerships between schools and external service providers such as public health might alleviate some barriers to implementing health interventions in Ontario secondary schools. [ABSTRACT FROM AUTHOR]

BACKGROUND Childhood is a critical period for developing food‐related skills and knowledge, known as food literacy (FL). Schools may be an important setting for interventions aiming to improve FL in children. This systematic scoping review aimed to characterize food literacy interventions in elementary schools. METHODS: Databases (PubMed, Web of Science, and EBSCO) were searched for FL interventions in elementary schools (students aged 4‐12 years). Studies were assessed according to design, duration, theoretical underpinning, and ascertainment of FL outcome(s). Interventions were assessed according to FL competencies (functional, interactive, and critical). RESULTS: After exclusions, 116 studies were eligible for review, including 105 original interventions. Interventions ranged from 45 minutes to 4 years. Social cognitive theory was the most referenced theory and common interventions included; classroom lessons, games, school gardens, food preparation, and cooking classes. Most studies measured FL outcomes quantitatively (96%, N = 111). All studies addressed functional FL (N = 116), while 77% (N = 89) addressed interactive FL and 28% (N = 32) addressed critical FL. CONCLUSIONS: This first international review of FL programs in elementary schools found great heterogeneity in school‐based FL intervention design and measurement of FL. Few interventions addressed critical FL, which should be a focus for future interventions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Disasters cause significant human and monetary destruction and society as a whole is underprepared to address them. Disaster preparedness education is not covered extensively enough for health professionals or for the general public. METHODS: A disaster preparedness education intervention was performed using a non‐randomized controlled trial of a convenience sample with a pre‐ and post‐intervention survey. The adapted Emergency Preparedness Information Questionnaire (EPIQ), a validated survey tool, was utilized. Participants came from a health professions educational enrichment program for students from under‐resourced high schools in the Kansas City area. RESULTS: The experimental group shows statistically significant improvement in knowledge of disaster topics post‐intervention. Of 18 adapted EPIQ tool questions, 17 show statistically significant improvement in disaster knowledge post‐intervention for the experimental group with significance set at p <.05 (range of significant p values.000‐.017). CONCLUSIONS: The education intervention was effective and cost‐efficient. Disaster preparedness education should be included in THE secondary school curriculum. [ABSTRACT FROM AUTHOR]

BACKGROUND Teen pregnancy continues to burden families, communities, and society. Programs continue to educate and impower youth and young adults to make positive behavioral decisions. METHODS: We evaluated a program aimed at high‐risk youth in after‐school programs. The goal of the program was to instill a sense of community and empathy, as well as sexual health decision‐making. The evaluation was a multiyear evaluation from external evaluators. RESULTS: There were statistically significant changes in empathy toward others in the community and a feeling of safety at school. Other positive changes noted were that students felt empowered to use condoms, other barriers, or birth control in the future when having sexual relations. The program noted a positive direction in students feeling they develop plans or goals and stick to them. CONCLUSIONS: These programs serve to instill a sense of empowerment, community, and responsibility in students. Evaluation data can serve as a metric of the merit of these programs and the impact on school health programs and communities. [ABSTRACT FROM AUTHOR]

BACKGROUND Most adolescents in the United States do not obtain sufficient sleep. Early school start times play a significant role in adolescent sleep deprivation. Most primary and secondary schools begin classes earlier than the 8:30 am. Perceived barriers to implementing a delayed school start time have been suggested in the literature but have not been quantified. This study explored perceived barriers and facilitating factors for implementing delayed high‐school start times. METHODS: A cross‐sectional study. School administrators who had delayed their school start times were invited to complete an online questionnaire ranking the perceived barriers and facilitating factors for implementing the delayed start times. RESULTS: Most commonly cited perceived barriers were lack of a tiered bus system, school athletes missing more afternoon classes, and less time after school for athletics. Most commonly cited facilitating factors were school‐administrator involvement in the decision‐making process and sleep education for family members and school administrators. CONCLUSIONS: Participants found that providing sleep education to fellow administrators, teachers, school staff members, families, and students and including them in the decision‐making process positively facilitated the implementation of delayed school start times. Perceived barriers to implementation may be overcome with support from stakeholders and planning committees. [ABSTRACT FROM AUTHOR]

BACKGROUND For youth between the ages of 10 and 24, suicide is the third leading cause of death, and results in approximately 4600 lives lost each year. Body weight status and bullying is associated with increase mental health disorders. METHODS: We analyzed data from the 2015 Youth Risk Behavior Survey, consisting of 15,506 students in grades 9‐12. Logistic regression analysis was performed using STATA13 to estimate the independent association of perceived weight status and bullying experienced at school and electronically to suicidal behaviors measured as—considered suicide, made a suicide plan, attempted suicide, and injurious suicide attempt, after controlling for socio‐demographics. RESULTS: Considered suicide and attempted suicide were significantly associated with very overweight, slightly overweight, very underweight, and slightly underweight weight perceptions. Made suicide plan was significantly associated with slightly and very overweight perceptions. Injurious suicide attempt was significantly associated with very underweight or very overweight perceptions. Bullying, at school and electronically was significantly associated with all suicidal behaviors. CONCLUSIONS: Examination of not just body weight status but body weight perceptions held by adolescent students, and the experience of not just in‐person bullying but also electronic bullying on youth suicidal behaviors is crucial. [ABSTRACT FROM AUTHOR]

BACKGROUND Positive youth development emphasizes that adaptive features of adolescence may contribute to teenage pregnancy prevention. METHODS: Using data from approximately 1300 seventh‐ninth graders, we describe positive youth development assets (external and internal) and their association with sexual risk taking. School‐, sex‐, and race/ethnicity‐stratified logistic or linear models assessed associations between developmental assets and 6 outcomes (continuous attitudes about teenage sex and marriage, abstinence intentions, and nonsexual risk‐taking behavior; dichotomous high risk‐dating behavior, friends' sexual activity, and prior sexual activity). RESULTS: Associations between developmental assets and youth sexual behavior differed by school, sex, and race/ethnicity. White female respondents showed the most consistent associations between higher amounts of each of the positive youth development assets and attitudes and behaviors conducive to delaying sexual activity while black youth showed the fewest associations. CONCLUSION: These results contribute to the positive youth development literature by identifying that relationships between assets and adolescent risk differs by race and sex. [ABSTRACT FROM AUTHOR]

BACKGROUND Choose Health: Food, Fun, and Fitness (CHFFF) is aimed at 3rd to 6th graders, and uses experiential learning, food preparation, active games, goal setting, and a family newsletter to target behaviors shown to decrease childhood obesity and chronic disease risk. This study aimed to evaluate CHFFF as intended in low‐income settings. METHODS: A quasi‐experimental design with delayed intervention was used. CHFFF participants in 27 after‐school and 28 in‐school groups in 5 New York counties in 2014 to 2015 completed a self‐report survey at initial enrollment, after a no‐intervention control period, and after receiving CHFFF. Statistical analyses were based on 561 3rd to 6th graders who completed all 3 surveys and participated in at least 4 of the 6 lessons. RESULTS: Compared to their control period, after receiving CHFFF, youth significantly improved in the following multi‐item dietary scores: overall dietary intake (p <.001), vegetable intake (p <.001), fruit intake (p <.01), soda/fast food intake (p <.05) and intent to consume soda/fast food (p <.001). Youth also reported reading Nutrition Facts labels and sharing about healthy eating with their family more often (both p <.001), and greater likelihood of having tried a new food (p <.001). CONCLUSIONS: Results provide evidence for the effectiveness of this curriculum in improving self‐reported child diet and related behaviors. [ABSTRACT FROM AUTHOR]

BACKGROUND: The National School Lunch and Breakfast Programs help to reduce food insecurity and improve nutrition. The Community Eligibility Provision (CEP) enables high‐poverty schools to offer breakfast and lunch at no cost to all students. This study examines associations between CEP and participation among students eligible for free or reduced‐price meals ("FRPM"), possibly eligible ("near‐cutoff"), or ineligible ("full‐price"). METHODS: Using data from the 2013‐2015 Healthy Communities Study, we compared school breakfast and lunch participation between 842 students in K‐8 at 80 CEP schools and 1463 students at 118 schools without CEP. Cross‐sectional difference‐in‐difference (DID) models compared meal participation among near‐cutoff and full‐price groups to that in the FRPM group. RESULTS: Overall, FRPM students had high participation in school lunch and breakfast at both types of schools. In adjusted DID models, lunch participation among near‐cutoff students was 12 points higher in CEP versus comparison schools (p <.05). Among full‐price students, breakfast participation was 20 points higher and lunch participation 19 points higher in CEP than comparison schools (p <.001). CONCLUSIONS: Community Eligibility Provision improves access to school breakfast and lunch in high‐poverty schools, particularly for students who are near or above the cutoff for FRPM eligibility. [ABSTRACT FROM AUTHOR]